Two New Zealand authors warn in this week's BMJ that Europe should avoid opening the Pandora's box of direct-to-consumer (DTC) drug advertising, and learn from what has happened in New Zealand.
The authors write that the European parliament is considering allowing the drug industry to have a much greater role in providing information to patients, with no restriction on the type of media. But they urge Europe to learn from the New Zealand experience. (New Zealand and the U.S. are the only two developed countries that allow DTC drug ads.)
Concerns about the impact of DTC ads on public health led the New Zealand Ministry of Health to reconsider the ad trend. But the advertising was allowed to continue with self regulation and a promised further review of compliance with the rules never took place.
So, the authors write, advertising became more widespread and proved extremely effective. For instance, intensive advertising of celcoxib and refecoxib on prime time television, aimed specifically at long term use in the elderly, resulted in widespread prescribing, despite early warnings of their cardiac risks. Similarly, just a few TV ads promoting oral terbinafine for toenail infections resulted in a doubling of national prescriptions within weeks.
Still, the New Zealand government has been unable to pass the necessary legislation to ban DTC ads, despite strong opposition from health professional groups and almost complete (90%) opposition from independent consumer and patient organizations.
The authors warn that allowing DTC ads in Europe will not help consumers make better decisions about medicines but will increase the pharmaceuticalization of health and will expose more of the population to new medicines (many of which offer little benefit over existing medicines) at a time when long term safety is unknown.
It will also rapidly drive up drug costs with major implications for already stretched health budgets - all of which will be of net harm to the overall public health, they warn.
I have to agree with the premise that pharma companies don't do anything without profit and nobody can convince me that their desire to educate the public is the sole purpose behind their advertising campaigns.
If Company X is putting $5 billion dollars into "educating" the public about its product, the cost of that expense has to come from somewhere. I can't see Company X or its shareholders agreeing to take it out of their pockets.